Vitreoretinal Diseases and Surgery

Macular Pucker
Retinal Surface Wrinkle

What is Macular Pucker?

The macula is the central part of the retina that is responsible for the detailed, clear vision necessary when reading or driving. If the retina develops a wrinkle on its surface, it can blur and distort the center of vision.

Causes of a Macular Pucker

A Macular Pucker (Epiretinal membrane) is a thin wrinkle or scar tissue membrane that lies on the surface of the retina. It commonly occurs with increasing age. While the majority of macular puckers just happen on their own, severe eye trauma, eye surgery or laser, or other pathologic eye conditions may be related.

Symptoms of Macular Pucker

Typically, people will notice gradual blurring of the central vision. Usually some amount of distortion of straight lines can be seen. While macular puckers can cause significant problems when reading or driving, they do not require urgent removal and are what we consider an “elective surgery.” Careful consideration of visual and life benefits must be weighed against the small chance of having a complication from surgery.

Vitrectomy Surgery

The pucker (epiretinal membrane) can be surgically removed with a procedure called a “Vitrectomy”. It is an outpatient surgery typically performed with the patient awake but comfortable in a “twilight” state. We place small instruments through the white part of the eye, remove the eye jelly, and “peel” the macular pucker off of the retina. The jelly is replaced with clear fluid that lasts the rest of life and often eliminates floaters. After surgery is performed, no strenuous activity, lifting, or straining can be performed for one to two weeks. Unlike cataract surgery where vision improves in a few days, the benefits of macular pucker surgery are not seen for weeks or months.